First Code Save

[CPhT]

We have a contract to provide mutual aid to a local municipal echo (non-transporting paramedic) company. Typically, they are supported by a dedicated ALS unit, but when they go out on a call, they can be supported by first available. As it turns out, we were the third call. My unit (BLS) was enroute to a transfer at a hospital when we got the call to flip it around for active choking at an elderly group home. To follow is my edited narrative:

B*** dispatched priority one to group home in ******** for reported choking, RFD on scene. B*** responded emergent (lights and siren), with no incidents. ATF pt of unknown age unresponsive on the floor of her bedroom, CPR in progress by RFD FF/EMTs. PT currently apneic, no radial or carotid pulse, pt appears cyanotic, skin cool. Pt has white frothy sputum and pink liquid coming out of mouth and nose. Staff at group home indicates pt started choking while eating lunch, staff called 911, then pt lost consciousness shortly thereafter.

Pt airway suctioned with portable unit, assisted RFD with hooking up the AED, allowed to analyze, no shock advised. CPR continued. Pt prepared for transport. CPR halted, pt log rolled, placed onto backboard, then rolled back into place. AED allowed to analyze, no shock advised. Pt carried via backboard to stretcher, CPR resumed. Pt secured and taken to ambulance. Pt loaded, CPR continued in back of ambulance. Pt airway suctioned again. RFD EMT readied combitube. AED analyzed again, no shock advised. Combitube inserted, inflated, placement confirmed with auscultation over stomach and both lungs. Combitube secured with tape. CPR continued, AED allowed to analyze as appropriate en route to hospital, no shocks administered.

Pt transported to ** hospital priority one (lights and siren) with RFD EMT driving **** ambulance, both **** EMTs in the pt compartment performing CPR. ** hospital contacted via HEMS radio patch. Upon arrival, pt unloaded and taken to resuscitation room, code team waiting. Report given to code team, who assumed care of the pt. B*** cleared of scene and returned to service after decon and restock.

So... I walked out the resusc room basically shaking and barely able to walk, as this was my first working code. I was fairly confident that the pt was dead in the truck, and taking her in for resusc was basically a formality. I was finishing typing my report and kind of calming my nerves when I was approached by one of the company paramedic field trainers. He came up and said "I heard you give report on the radio, and heard you bring the pt in, and I had to stop in and see it. You did an incredible job on the road, and looking at the patient, you gave her every chance to live". It helped to get feedback like that, and I really needed it at that point. He walked away and went into the resusc room. He came back out, pulled me outside into the parking lot, and said "Are you ok? You don't look good. You just need to take a minute. Oh... by the way... she has a pulse".

I didn't believe him, so I went back into her room, and sure enough, she was in NSR on the hospital monitor, pumping away at 78. They had her on a vent, but she was beating. I'll flat out admit that I pretty much broke down. The doc saw me standing there and said "Are you one of the ones who brought her in?". I nodded. He said "You guys did good. She's alive. Not sure for how long, but you did everything right and did a good job getting her to us".

I went back to that hospital later in the shift for a transfer. I peaked in the resusc room, and it was empty. I asked one of the nurses where the pt was, and they said they had moved her up to the floor about 2 hours ago. That sure made the rest of my shift go by easy.

[paramedicmike]

Strong work!

Don't get used to them living, though. It doesn't happen often. So enjoy this feeling while you can. It might be awhile before it happens again.

[eCamp91]

Great job! It is stories like this that made me want to be an EMT.

Again, good job.

[island emt]

Enjoy the thrill of a save. As others have said they are few and far between.

[CPhT]

Last night we had a transfer out of the hospital where we took this patient. Just for curiosity sake, I stopped at registration and asked about her. They said she was transferred up to ICU later in the night that we brought her in.

I slipped up to ICU as we still had a couple of minutes before our call was scheduled. The nurse at the ICU desk said the pt was take off feeding tube and ventilator at family request earlier in the morning and died shortly thereafter. Apparently, the pt had pretty significant neurological deficit, shown by some tests done by the neurologist. She never regained consciousness. Plus, the pt kept slipping into pulseless electrical activity.

Temporary victories. The way I see it, at least the family got to say goodbye to a living relative, rather than a cold corpse. I'm not gonna lie though, I hugged my wife a little harder last night than normal, and may have been choking back a tear or two.

[BushyFromOz]

Despite the awesome survival to discharge rate here i have yet to have one of mine leave hospital alive, but ive kept a few organ donors going long enough to helpe some other oor begger out

[DwayneEMTP]

Hey Bushy! Good to see you!

Yeah, I've gotten pulses back on around 50% or the arrests that I've run but have never had one leave the hospital...And with my current gig I'm guessing my odds are around 100% for that not happening.

(No CPR culture, long response times, several hour drive to the hospital minimum.)

[Arctickat]

Yeah, I'm at 3% for 1 yr survival, 29% for less than 1 wk survival, and the rest didn't have a prolonged rosc.

[DwayneEMTP]

Yeah, I'm at 3% for 1 yr survival, 29% for less than 1 wk survival, and the rest didn't have a prolonged rosc.

Do you track those numbers or are those numbers tracked by your company for each person? Another way?

I don't doubt you in the least, I'm just curious. I'm not aware of any place that I've ever worked that would have that available, but it seems like it could possibly be valuable?

[craig]

Despite the awesome survival to discharge rate here i have yet to have one of mine leave hospital alive, but ive kept a few organ donors going long enough to helpe some other oor begger out

what does that say about CSU trained, vic ambos bushy?................told you to stay in nsw..